Lactose Intolerance

Lactose intolerance is a general description used for people who have some degree of difficulty digesting lactose. It can also be described as ‘Lactase deficiency’, because it is caused by the reduction (although not necessarily an absence) in the amount of active lactase, the enzyme responsible for the digestion of lactose. People become lactose intolerant when their bodies don’t make enough lactase. This can happen naturally as people get older and is often an inherited trait. It is also seen in infants with colic.

Dairy foods constitute a key element of a healthy diet, however in some cases they can create uncomfortable symptoms – lactose intolerance may be the culprit. People with lactose intolerance have difficulty digesting the sugar in milk called lactose. When they eat too much lactose it passes through the digestive system without being digested and absorbed, often causing gas, bloating, cramps and/or diarrhoea.

There is an enzyme in the body called lactase that breaks down lactose so it can be absorbed. People become lactose intolerant when their bodies don’t make enough lactase. This can happen naturally as people get older and is often an inherited trait. It is also seen in infants with colic.

Temporary lactose intolerance can be caused by conditions that damage the gut, such as chronic diarrhoea. Once the gut has healed, people then can resume eating lactose.

Is Lactose Intolerance serious?

Not usually. there are exceptions, for example, if it occurs in infants, or in people where lactose is a major component of their diet. Lactose intolerance means temporary discomfort, and some minor adjustments to your diet will need to be made. However, if whole food groups, such as dairy products are eliminated from the diet, other nutritional problems can occur.

What are the dangers of lactose intolerance?

The most important consequence of lactose intolerance is caused by making drastic changes to your diet which are unnecessary or based on incomplete information. Elimination dairy products means that you eliminate the best source of dietary calcium. Calcium is essential for good health and bone strength. We need 800-1200mg of calcium each day to replenish our normal losses. About 70% of our calcium comes from dairy products so three servings of dairy foods a day makes good sense. there are vegetables that contain calcium but you would need to eat a kilogram of broccoli to get as much calcium as that in a 40gm slice of cheese.

Insufficient calcium intake increases the risk of osteoporosis. This is a serious and in some cases a life threatening health problem. High calcium diets may also help prevent colon cancer.

The exact number of people with lactose intolerance in Australia is not known but certain cultures are more affected by it, including Aborigines, Maoris, South East Asians and some people of Mediterranean descent, according to a recently released CSIRO report, Lactose: A Review of Intakes and of Importance to Health of Australians and New Zealanders 1994.

Suspicious Signs

If you suspect you might be lactose intolerant take the time to see your GP. You can rest assured that he/she will be well acquainted with this condition, particularly as 23,000 copies of the above-mentioned CSIRO report have been distributed to GPs across the country, according to its author and research nutritionist, Dr. Lynne Cobiac.

GPs are well versed in the diagnosis and treatment of lactose intolerance. Importantly, they also can determine whether another more serious condition is causing your symptoms, so your first port of call should be your family doctor.

Never self diagnose. If you are lactose intolerant but leave it untreated further complications can occur.
On the other hand, if you treat yourself by cutting out all dairy products without seeking proper dietary advice, you may be missing out on calcium and other valuable nutrients.

What if I like milk, but I don’t want to suffer?

If you are really sensitive to lactose and like to drink milk in large quantities, larger than 200-300ml at a time, choose milk with regular fat contents or use milk as part of a meal. The higher the fat content the slower the passage through the intestines. This gives the lactase enzyme more time to act on the lactose and digest it. There are also lactase products available from most pharmacies in tablet or drop form. You add these preparations of lactose enzyme to milk and they digest the lactose for you so you can drink treated milk without discomfort. In some states fresh and Longlife versions of low lactose milks are also available.

You can also try soy beverages. Soy beverages are highly processed foods which have been formulated to mimic cow’s milk. They are more expensive than cow’s milk but can be used as a substitute if milk would cause a problem. If you are planning to use a soy beverage make sure that you choose a brand which is calcium fortified. Check the label to ensure that there are 290mg of calcium for every 250ml serve. If you are substituting soy beverage you can still eat cheese, yoghurt and other dairy products to supply sufficient calcium for good health.

The recommended dietary intake (RDI) for calcium for adults is 800mg per day. During pregnancy and lactation, for women over 54, and for teenagers, the RDI ranges from 1000-1200mg per day.

The Sensible Approach

If lactose intolerance is confirmed there are some simple steps you can take to treat it while at the same time meeting our need for calcium and other nutrients. Dr. McIntyre suggests you:

Avoid high lactose foods and beverages, such as Dairy Products and milk powders.

Use lactose-free milk substitutes, such as soy milk or rice milk.

Use lactose-reduced products, such as Lactaid milk.

Consider using tablets or drops that add lactase to food before you eat or drink it. (Available from your local pharmacy )

Eat foods containing lactose in small doses over an extended period of time and with other foods.

Extra Help

Some lactose intolerant people may need specialist help to modify their diet. A dietician can provide a list of low lactose foods, explain which foods to avoid, and at the same time, ensure you are maintaining a well balanced diet.